Independence, Inc. | Disability Advocacy Award Nominations
Independence, Inc. is seeking nominations for the following awards:

Advocate of the Year & Youth Advocate of the Year

Advocate of the Year
The Advocate of the Year award honors a leader committed to advancing disability rights.

The award is given to an individual who has fought hard to:
• Improve conditions and opportunities in the community for people with disabilities.
• Increase community awareness of issues related to disabilities.
• Remove barriers for people with disabilities.
• Improve community participation for people with all types of disabilities.

Eligibility
The Advocate of the Year nominee must reside within the eleven county service area of Independence, Inc. Independence, Inc. employees and board members are not eligible for nomination.

Youth Advocate of the Year
The Youth Advocate of the Year award honors a young leader with a passion for disability advocacy.

The Youth Advocate of the Year is given to an individual who has fought hard to:
• Inspire youth to become future leaders and advocates for the disability community.
• Improve conditions and opportunities in the community for people with disabilities.
• Increase community awareness of issues related to disabilities.
• Remove barriers for people with disabilities.

Eligibility
The Youth Advocate of the Year nominee must be between the ages of 12-24 and reside within the eleven county service area of Independence, Inc. This nominee should have a disability.

The 2018 Advocate of the Year and Youth Advocate of the Year awards will be presented on Thursday, July 19, 2018 at the 8th Annual Celebrating Independence Picnic. The event will be held from 5-7pm at Roosevelt Park (Shelter #3 & #14) in Minot, North Dakota.

Nominations must be submitted by Monday, June 11, 2018.

Nominator Contact Information
Name *
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Title *
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Agency/Employer *
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Phone Number *
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Email *
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Mailing Address *
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Nominee Contact Information
Name *
Your answer
Phone Number *
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Mailing Address *
Your answer
Email *
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Award Category *
Tell us about the nominee. *
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Why are disability rights important to the nominee? *
Your answer
How has the nominee helped improve the conditions and opportunities in the community for people with disabilities? *
Your answer
What steps has the individual taken to remove barriers for people with disabilities. *
Your answer
If you are nominating a youth advocate, please complete the following section.
How has this nominee inspired other youth to become future leaders and advocates for the disability community?
Your answer
What plans does the individual have for the future?
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